Everyone affected by breast cancer knows the physical hardship it can bring. What’s less commonly talked about, but also important, is how breast cancer affects patients’ and survivors’ mental health.

A history of mental illness can be exacerbated by a breast cancer diagnosis, and the rigors of treatment — while life-saving — are difficult, leaving many women depressed, anxious, or feeling alone.

October is Breast Cancer Awareness Month, a time to recognize women affected by breast cancer and raise awareness about breast cancer prevention. Many breast cancer survivors have spoken up about their struggles with mental illness. To honor their voices, here’s what you need to know about breast cancer and mental health.

Breast Cancer Can Negatively Impact Mental Health

If you or a loved one has been diagnosed with breast cancer, you know firsthand that a diagnosis can have long-lasting mental health effects. From anxiety about the future to the stress of treatment, it’s totally normal to feel a mix of intense emotions after a breast cancer diagnosis.

While normal, this turmoil can cause long-term mental health challenges. Studies show that a majority of people with breast cancer will subsequently develop symptoms of PTSD, and these symptoms tend to last longer than a year. Even after successful treatment, fear of recurrence affects many women and can be so severe it negatively impacts their quality of life.

After a breast cancer diagnosis, a woman’s relationship with her body might change as well. While life-saving, mastectomies can decrease women’s body confidence, impact their relationships to their sexuality, and have a negative effect on overall mental health.

Your Mental Health Affects Your Physical Health

Mental illness doesn’t just cause distress to breast cancer patients, it can actually impact their physical health, including their mortality risk.

Pre-existing mental health conditions can make it harder for a patient to cope after a breast cancer diagnosis, in turn negatively affecting their long-term physical and emotional health. A history of trauma can increase breast cancer survivors’ risk of chronic pain even after treatment. More alarmingly, several studieshave found that women with depression have a higher risk of mortality both from the cancer itself and from other factors — up to double the risk of death in elderly women.

While grim, these findings make sense. As the American Psychological Association points out, a breast cancer diagnosis is a traumatic event and it’s normal to have a range of emotional reactions to the diagnosis. Meanwhile, mental illness can exacerbate these natural feelings, making it even harder for patients to do things that benefit their health, like eat healthy foods, exercise, connect with friends and family, and perhaps most importantly, comply with their medical treatment.

The good news? Prioritizing mental health can actually be lifesaving. Research shows that women with breast cancer who avail of mental health support have a decreased risk of recurrence and death, even years after therapy.

Seeking Support for a Breast Cancer Diagnosis

If you’ve been diagnosed with breast cancer, it’s a great idea to talk to a therapist. A therapist can help you cope throughout your breast cancer journey.

The APA recommends a combination of group therapy, which allows women to share emotional support, and individual therapy, which helps women learn problem-solving skills and alter patterns of negative thinking. A therapist can also help you work through body image or sexuality issues related to a mastectomy or treatment in general.

While breast cancer and mental illness may both feel like insurmountably large problems, you can take simple steps every day to feel better. Staying as active as you can, focusing on healthy eating including lots of fruits and vegetables, and reaching out to friends, family, a support group, or a faith group can all help, says the CDC.

You also don’t have to be a medical professional to give support to people in your life with breast cancer. Social support matters, too. Research shows that having supportive intimate partners and family members increases breast cancer survivors’ overall wellbeing.

Caretakers Deserve Care, Too

If someone in your life is diagnosed with breast cancer, it’s normal to want to do everything you can to support them. That’s a great impulse, and your loved one deserves all the care and support you can offer. But in looking out for your loved ones, don’t forget to care for yourself.

A breast cancer diagnosis doesn’t just affect the mental health of the person with cancer; it can also have a serious effect on the mental health of family and friends. One study revealed that men whose partners had breast cancer were at an increased risk of hospitalization for an affective disorder like depression subsequent to the diagnosis. While it’s easy to feel that you don’t deserve support since you’re not the one with the diagnosis, that’s simply untrue: taking care of yourself makes you better able to care for your loved ones.

Personal Support is Crucial

A breast cancer diagnosis can make patients and their loved ones feel powerless, and mental health issues, while common, can exacerbate this feeling. Some things truly are outside of our control, and accepting this can make you feel understandably overwhelmed. But there are simple things we can do to support the mental health of loved ones with breast cancer every single day.

One of the most effective strategies is also the simplest: simply be there.

If you or a loved one are struggling after a breast cancer diagnosis, you deserve support. The American Cancer Society has a range of mental healthresources for people with cancer and caretakers. You can also consult the Susan G. Komen Foundation’s list of breast cancer support groups.

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